Britain Defies U.S. on Gag Rule

t is obvious that nothing good is happening
domestically on reproductive rights. Internationally, however, a
small bright spot appeared in mid-February when Britain’s Department
for International Development announced that it would contribute
$5.3 million to organizations that have been denied family planning
money because of the Mexico City policy, i.e., the Global Gag Rule.

According to Population Action International (PAI), the Gag Rule,
first imposed by Ronald Reagan in 1984, rescinded by Bill Clinton
in 1993, and re-imposed by George W. Bush in 2001, has forced some
family planning clinics to close and has led to staff reduction
and cutbacks as well as fee hikes for reproductive health services
throughout much of the world. In addition, PAI reports that “family
planning organizations that reject the Gag Rule have been unable
to obtain donated contraceptives on which the women and men they
serve depend.” PAI researchers also found that in the five
years since Bush reinstituted the Gag Rule, numerous countries have
seen their healthcare referral networks collapse. Furthermore, reductions
in technical assistance, as well as the loss of condoms previously
supplied by U.S. agencies, have had a deleterious impact not just
on pregnancy rates, but on STD transmission.

British Development Minister Gareth Thomas told the press that the
grant would provide start-up funds to the Global Safe Abortion Program
developed by the International Planned Parenthood Federation (IPPN).
The need, he announced, is blatant and replacing lost financing
for reproductive healthcare has been long in coming. Thomas described
the more than 19 million illegal abortions that occur worldwide
each year and told reporters that between 70,000 and 76,000 women,
most of them young and poor, die from sepsis and hemorrhaging directly
linked to unsafe surgeries. “The Global Safe Abortion Program
will work to support abortion and improve access to abortion services
and will help those groups that have been forced to cut back on
reproductive health services,” he said. “Maternal deaths
represent one of the starkest indicators of inequality within, and
between, rich and poor nations. Much more must be done to ensure
that those most vulnerable have access to the care and services
they need.”

The Gag Rule has long rankled international activists because it
prohibits the State Department and USAID, the world’s largest
financier of family planning and women’s health services, from
giving monies to non-governmental organizations that perform abortions—unless
the abortion is needed to save the pregnant woman’s life or
is to end a pregnancy resulting from rape or incest—or that
counsel women about their options or refer them to abortion providers.
Organizations that accept money from the U.S. are further barred
from lobbying to make abortion legal or working to make the procedure
more accessible in nations where it is already lawful.

“Family planning is a key entry point for many women to health
care,” says Shirine Mohagheghpour, assistant director of Planned
Parenthood Global Partners. This is why she and her colleagues are
thrilled by Britain’s decision. Furthermore, she is delighted
that Britain is stepping in to fill the gap because Britain is typically
seen as a U.S. ally. “This is an interesting challenge to the
U.S., a very public slap in the face. Britain is saying, ‘We
cannot abide by women dying from the lack of family planning.’
Because of the strong relationship between Britain and the U.S.
government on other fronts, this is a fascinating distancing move,”
she says.

Mohagheghpour
recently returned from Africa where she witnessed the importance
of contraceptives in people’s everyday lives. “Everything
in Africa is so interconnected,” she says. “I saw how
the drought in Tanzania is exacerbated by more births, how a higher
birthrate means that more people are impacted by the water crisis.
All over Africa women are dying from too many unintended pregnancies
and as a consequence of illegal or unsafe abortions.”

Mohagheghpour met scores of young people in Tanzania and Uganda
who described their desire for contraceptives and documented their
inability to get them. “I heard teenagers say that they’d
finally mustered up the nerve to go to a clinic only to be told
that the facility had run out of condoms.”

Laura Katzive, Deputy Director of the International Legal Program
at the Center for Reproductive Rights, agrees and hopes the new
money will reinvigorate debate in countries where activists have
not been able to advocate abortion because of the Gag Rule. “There
has been a climate of censorship, a chilling effect, since the policy
was reinstated,” she says. “It has inhibited many NGOs
from taking a position on abortion which makes it much harder to
have an open dialogue.”

What’s more, Katzive believes the Gag Rule censors abortion
proponents by making it impossible for them to talk about overturning
restrictive policies. On the other hand, she says that the deck
is stacked because those who favor abortion bans or limits on access
can openly speak their minds without fear of offending U.S. grant-givers.
“Kenya is in the midst of a heated abortion debate,” Katzive
says. “It is illegal there except for life endangerment. The
Gag Rule has stifled reproductive health providers from participating
in the process.”

International health activists repeatedly stress the impact that
fear of financial reprisals has on the provision of medical care
throughout much of the world. For example, Katzive explains, directors
of one USAID-funded project in Africa became intimidated shortly
after the Rule was reinstated and scaled back their efforts to promote
post-abortion care. Although the group continues to provide the
service, it is no longer advertised on their website and the staff
cancelled the community education component of the program. Clinics
in Central and South America and in other parts of Africa have taken
similar actions.

Meanwhile, the U.S. has not publicly acknowledged Britain’s
move to replace lost USAID monies, but Bush’s 2007 budget includes
$357 million for international family planning, $79 million less
than was included in fiscal 2006.

A bipartisan group of pro-choice Congresspeople recently introduced
the Global Democracy Promotion Act, an annual effort, which would
add $600 million to USAID’s 2007 funding allocation to “support
contraceptive procurement, logistical support, training, and integration
with HIV/AIDS activities in developing countries.” Supporters
say passage would help fill the “decency gap” that exists
because of the Global Gag Rule.